| NPI | 1801236971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 68437-20) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD61095314) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WA 61095314) | |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2024-02-22 |